根尖囊肿前牙行即刻种植联合引导骨再生术对骨形成的影响

The effect of immediate implant combined guided bone regeneration technique on the bone formation of anterior teeth with apical cyst

目的评价前牙区根尖囊肿摘除后行即刻种植联合同期引导骨再生术(GBR)的骨形成情况。方法本研究入选共20例患者29颗无保留价值的残根,所有患者就诊时均要求种植修复,排除手术禁忌后拔出残根,行囊肿摘除术+即刻种植+GBR。术后6个月行二期手术,8个月冠修复,永久修复后随访1年,观察种植体及义齿的稳定性和牙片变化,对临床效果进行评价。结果除1枚种植体松动明显,其余种植体植骨区新骨形成良好,复诊期间均未发生松动脱落和胶原膜暴露;种植体周围龈缘无红肿、溢脓;患者自我感觉良好,无红肿疼痛等不适,咀嚼功能好。X线片显示种植体1年期骨吸收量均小于1.2 mm;植入骨粉钙化良好。本组病例临床成功率为96.6%。结论前牙区根尖囊肿摘除术同期行即刻种植手术+GBR能够减少骨吸收程度,并有助于新骨形成,可作为一种可靠而有效的治疗方法。

Objective To evaluate the bone formation of immediate implant in combination with guided bone regeneration（GBR） technique in restoration of anterior teeth with apical cyst.Methods Twenty-nine residual roots in 20 patients who asked for implant treatment and had no surgical contraindications were included. The residual roots were extracted and cystectomy was performed,followed by immediate implant and GBR. The second stage surgery was performed 6 months later and restorations were cemented in 8 months postoperatively. One year follow-up was performed to observe the stability of the implants and crowns. X-ray was also taken to evaluate the bone loss around the implant.Results Only one implant was loose,the rest implants were demonstrated to have good clinical results without loosen,dislocation or collagen membrane exposure. The gingival margins around the implants were free from suppuration and porrhea. High patient satisfaction and good masticatory function were reported during the follow-up. X-ray showed bone resorption was less than 1.2 mm for one year and good calcification of implanted bone powders. The clinical successful rate was 96.6% in this study. Conclusion For the cases of anterior teeth apical cyst,apical cyst cystoectomy in combination with immediate implant surgery and GBR technique can be used as a reliable and effective method to reduce the absorption of alveolar bone and facilitate new bone formation.